Organization
WOODLANDS ORAL & MAXILLOFACIAL SURGERY PC
Active
Other names
Mark A. Crane DDS MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK ALLEN CRANE M.D.,D.D.S. (PRESIDENT)
(928) 214-7052
Entity
Organization
Contact information
Practice address
1635 S PLAZA WAY, FLAGSTAFF, AZ 86001-7102
(928) 214-7052
(928) 214-7059
Mailing address
1635 S PLAZA WAY, FLAGSTAFF, AZ 86001-7102
(928) 214-7052
(928) 214-7059
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
26402
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
545345
—
AZ
Enumeration date
01/09/2007
Last updated
08/22/2020
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